Parties 'not being honest' about scale of NHS funding needed to tackle healthcare crisis

Health Foundation calls on politicians to "level with the public" as it highlights £38bn funding gap
Photo: Adobe Stock

By Tevye Markson

20 Jun 2024

The NHS is facing a funding gap of £38bn to make the improvements needed to fix the health crisis posed by near-record waiting lists for hospital treatment, slipping targets for services such as cancer treatment and record-low public satisfaction, a think tank has warned.

The Health Foundation said the next government must "level with the public about how much it will cost to meet the challenges facing the NHS and the trade-offs this will require" – saying political parties have so far been "unwilling to spell out the difficult choices on public spending and taxation that will confront the next government".

Analysis published today by the think tank projects a £38bn shortfall in the funding needed to delivery sustained improvement to healthcare by the end of the next parliament.

The Health Foundation said spending pledges made by both Labour and the Conservative Party are “so far falling a long way short of this”, despite both parties making commitments to fix the health crisis.

The Department of Health and Social Care’s budget is set to rise by £7.6bn to £196.9bn by 2029-30 under current spending plans. But the Health Foundation found the next government will need to increase this by an extra £38bn to meet rising care needs and deliver significant improvements in the NHS.

The think tank projects a need to boost healthcare funding in England by 3.8% per year in real terms over the next ten years – which it says is broadly in line with the historic average. The foundation said there would need to be higher annual growth of 4.5% in the first five years as the NHS recovers from Covid and invests in modernising services, equating to an extra £46bn of funding in 2029-30.

It said the around £8bn increase in public spending forecast by the Office for Budget Responsibility for the next parliament – which amounts to a 0.8% increase per year – means there is a funding gap of £38bn. 

The 3.8% annual growth scenario "would see sustained improvement", improving services and addressing the electictive care backlog over a ten-year period, a slower timescale than the two main parties have pledged, the think tank said. It would also enable a fundamental shift in the NHS to focus on prevention, better management of long-term conditions, caring for more people out of hospital, uplifts in capital and the public health grant,and pay growth to attract and retain staff.

The Health Foundation said the Tories and Labour have both promised to deliver similar improvements but have yet to set out a convincing plan for how they would fund them.

In separate analysis of both main parties' manifestos, the Health Foundation said the Conservative plan was "ambitious" and the Labour plan was a "bold vision" but described both as lacking critical detail on how the aims will be achieved.The two manifestos implied spending increases of 0.9% and 1.1% per year respectively, the think tank added.

The think tank said the analysis “raises serious questions about the trade-offs facing the next government in balancing the funding needed by the NHS, pressures on other public services and levels of taxation”.

Anita Charlesworth, director of the Health Foundation’s REAL Centre, said: ‘The health service is in crisis and all the main political parties have said they want to fix it – yet the funding they have so far promised falls well short of the level needed to make improvements. 

‘Politicians need to be honest with the public about the scale of the challenge the NHS faces and the reality that an NHS fit for the future needs long-term sustainable investment. Honesty about this has so far been conspicuously lacking from the general election debate, with both the main parties unwilling to spell out the difficult choices on public spending and taxation that will confront the next government.”

Charlesworth added that the scenario it has set out is “not overly ambitious – it is broadly in line with the pledges set out by the main political parties and public expectations, and assumes the NHS can deliver challenging improvements in productivity”.

Dr Layla McCay, director of policy at the NHS Confederation, a membership body which represents 1.5 million staff in the healthcare system in England, Wales and Northern Ireland, said the analysis is a “stark warning for the next government that trying to achieve the NHS improvement that they aspire to deliver with current investment plans could lead to a potential £38bn health service shortfall in five years' time”.

“Put simply, if a new government is going fulfil campaign promises to tackle NHS backlogs and improve performance then it will have to invest further,” she said.

Read the most recent articles written by Tevye Markson - FSA chief Emily Miles to return to Defra

Share this page